Introduction: One of the more difficult questions in the management of posttraumatic osteomyelitis is the decision for removing or retaining infected hardware. We know that skeletal stabilization in posttraumatic osteomyelitis is necessary for controlling infection. However, in the presence of internal fixation, microorganisms are protected in a biofilm adherent to the implant surface. The decision to retain or remove infected implants is individualizated and depends on several factors: status of bone healing, stability provided by the hardware, fracture localization, and time since fracture fixation.

Material and Method: We used in our Hospital the algorithm proposed by Patzakis and Zalavras1 in 2005. The objective of our lecture is to define the decision to remove the implant with some case reports.

Conclusion: The management of infected hardware in patients with postraumatic osteomielitis in long bones is difficult and it is necessary to study each cases individualizated but it is necessary to have a guidelines.

We must remove the implant:

If the fracture has healed.

Introduction: To introduce a unit of bone and joint infections and to show the first result after a-two-year clinic experience.

Material and Methods: The bone and joint infections represent the most fearsome difficulty for surgeons. In order to deal with this kind of patient a multidiciplinary team work is required. In our Health Centre, in the year 2001, it has been made up a unit, directed by an Orthopedic surgeon, Head doctor of the Centre, and which is formed by two more Orthopedic surgeons; belonging the first one to the unit of plastic surgery and the second to the infection commission; furthermore, there is a specialist in internal medicine, a specialist in family and community medicine, a specialist in rehabilitation, a specialist in laboratory and clinic analysis and a nurse. Five beds of restricted entry and a monographic consult are also available. The way of work consists of two-day-a-week combined visists to floors and a weekly clinic session. Outpatients are seen by Orhtopedic surgeons of the unit, the internist doctor, the rehabilitators in their everyday consults and the monographic consult of the enfermary. Patients who are admitted in the unit are affected with bone and joint infection: Only exceptionally, patients in need of hospital isolation and with tissue infections caused by germs, are admitted; namely, Acinetobacter baumannii, Staphylococcus methicillm-resistant.

Results: Results of the unit after two-year clinic experience are presented:

We have treated a total of 82 patients, 78 of them where men and 4 women, between 18 and 58 years old. Most of the patients were included in, first in the 40–50 (21 patients) and second in the 30-40 (26 patients) years-old range. Out of the 82 patients, 64 had ostheomyelitis, 10 arthritis and 8 soft tissue infection. The first localization for the ostheomyelitis has been in tibia (30 cases) and in femur (8 cases). The etiology is distributed in: 32 infections after osteosynthesis and 27 after an open fracture. The germs mostly isolated were Gram positives: Staphylococcus coagula negatives (21), staphylococcus methicillin-sensitive(14) y enterococcus (5); Gram negatives: Pseudomona aeruginosa (14), Serratia (3), Enterobacter (2).

Conclusions: In our opinion a unit of bone and joint infections as a multidiciplinary medical team work improves the clinic quality.